For decades, Samuel S. Epstein, M.D., Professor of Occupational
and Environmental Medicine at the University of Illinois Medical
Center (Chicago), has studied toxic and carcinogenic substances
that are found in environmental pollution and in consumer products.
During this career, he has been a consultant to the U.S. Senate
Committee on Public Works and a member of the Environmental Protection
Agency's Health Advisory Committee and the Department of Labor
Advisory Committee on the Regulation of Occupational Carcinogens.
Congress has frequently asked for his testimony; his expertise
provided a basis for banning DDT, Aldrin, and Chlordane. Epstein
is also recognized as the leading international authority on
the hazards of bovine growth hormone (rBGH).

Epstein's scientific knowledge and his governmental experience
led him to write The Politics of Cancer, published by
Sierra Club Books in 1978. In it, he explains the rationale behind
animal testing and epidemiological studies, the two methods currently
used to determine a substance's carcinogenicity. Then, Epstein
documents the relationships between exposure to environmental
and occupational carcinogens and rising cancer rates. Exposure
to many of these carcinogens is avoidable; they can be replaced
by less harmful substances or used and disposed of with far greater
care. Industry and the cancer establishment have balked at these
solutions. Twenty years after the publication of The Politics
of Cancer, Epstein has produced The Politics of Cancer
Revisited, which contains a revised and expanded version
of his 1978 classic and updated information on scientific developments
and public policy. In it, Epstein charges the cancer establishment
with "major responsibility for losing the winnable war against
cancer."

The Politics of Cancer Revisited is a monumental work.
Part I of the book explains the limitations and accuracies of
cancer research. It also contains case histories of the research
and political wrangling over several carcinogens, including asbestos,
vinyl chloride, bischloromethylether, benzene, tobacco, red dyes
#2 and #40, saccharin, acrylonitrile, female sex hormones, pesticides,
aldrin/dieldrin, chlordane/heptachlor, and nitrosamines. Government
and cancer establishment policies through 1978 are also presented.
In Part II, Epstein spends less time on documenting specific
cases and more on challenging and debunking current cancer establishment
policy and its U.S. and British apologists. Much of this section
takes the form of articles, reports, and press releases dated
from 1987-1998. Appendices include documentation on the hazards
of hormones in meat and milk, the many factors that contribute
to breast cancer, and citizen petitions to the FDA regarding
avoidable cancer risks.

Despite the cancer establishment's claim
that "we" are winning
the war against cancer, the incidence of cancer continues to
increase. Epstein admits that many factors - including genetic,
endocrine, immunological, viral, biochemical, and psychological
factors - contribute to the development of cancer. The main factor
that has brought about the dramatic increase in cancer over the
last century, however, is the multitude of carcinogenic substances
in the workplace and environment. The Preface to the First Edition
of the 1978 book states: "Cancer is caused mainly by exposure
to chemical or physical agents in the environment . The more
of a carcinogen present in the human environment, hence the greater
the exposure to it, the greater the chance of developing cancer
from it . There is no known method for measuring or predicting
a 'safe' level of exposure to any carcinogen below which cancer
will result in any individual or population group."

Back in 1978, experts from the National
Cancer Institute, the National Institute of Environmental Health
Sciences, and the
National Institute of Occupational Safety and Health used detailed
epidemiological and statistical evidence to prepare a highly
respected HEW report entitled, "Estimates of the Fraction of
Cancer in the United States Related to Occupational Factors." In
this report, the experts estimate that up to 38 percent of
all cancer deaths during the years 1978-2008, would be linked
to six 'high exposure,' occupational carcinogens: asbestos,
arsenic, benzene, chromium, nickel oxides, and petroleum
fractions. The estimates consider the effect of these carcinogens
on workers only. It does not include their effect on the workers'
families or household members (Workers bring carcinogenic chemicals
and dust into their homes via clothes and skin), nor the effect
on community members who are exposed to these substances via
industrial pollution. Also, the report disregards the effect
of radiation and all other known occupational carcinogens.

People are also exposed to industrial
chemicals via consumer products. Epstein discusses several
common carcinogens found
in various products, foods, and prescription drugs. For example,
diethanolamine (DEA), a carcinogen that is easily absorbed through
the skin, is used in many cosmetics, soaps, and toiletries. Permanent
and semi-permanent dark hair dye contains hazardous ingredients
that produce 20% of the non-Hodgkin's lymphoma found in U.S.
women. Food colorings, pesticides and fungicides, nitrites, and
hormones are among the cancer-causing ingredients currently permitted
in food. Over 95% of American beef cattle received carcinogenic
growth-promoting hormone implants in 1990. Not only is the food
adulterated, the packaging can be hazardous. Microwave packaging,
plastic wrap, and cling film contain carcinogenic chemicals that
can migrate into the food. Finally, prescription drugs, according
to Epstein, "may pose the single most important class of unrecognized
and avoidable cancer risks for the U.S. population." He cites,
as an example, Evista, a new anti-osteoporosis drug that causes
ovarian cancers at one-third of the recommended dose.

Industry, with the support of academic consultants and members
of the cancer establishment, has intentionally downplayed these
cancer risks. Despite strong evidence to the contrary, the cancer
establishment attributes only 4% of cancer moralities to occupational
exposure. Why? In Part II, Epstein documents the incestuous relationship
of the National Cancer Institute (NCI), American Cancer Society
(ACS), major cancer clinics, and industry. For example, Memorial
Sloan-Kettering Comprehensive Cancer Center owns thousands of
shares in cancer pharmaceutical companies - Bristol Myers, Eli
Lilly, Squibb, and others. A 1988 list of the Center's overseers
includes directors, presidents, and CEOs of drug, petroleum,
and tobacco companies. The three-member, Presidentially-appointed
Cancer Panel that controls NCI policies has included senior drug
company executive and member of Sloan-Kettering Board of Overseers
Benno C. Schmidt and Chairman of Occidental Petroleum, Armand
Hammer.

One blatant example of the conflict-of-interest within the cancer
establishment that Epstein cites is Zeneca Pharmaceuticals' funding
of National Breast Cancer Awareness Month. Zeneca Pharmaceuticals
has funded this multimillion-dollar ACS and NCI promotion that
encourages women to troop in for an annual mammogram since 1984.
(Because radiation is carcinogenic, Epstein is very critical
of routine mammograms in pre-menopausal women, whose breasts
tend to be highly sensitive to radiation). Zeneca manufactures
tamoxifen, the top-selling breast cancer drug. Zeneca Pharmaceuticals'
parent company is Imperial Chemical Industries, one of the world's
largest manufacturers of chlorinated and other industrial chemicals,
including chemicals that are known to cause breast cancer. None
of the publications used for National Breast Cancer Awareness
Month mentions the well-documented role of carcinogenic industrial
chemicals in breast cancer.

Epstein lambasts the cancer establishment,
with its close ties to industry, for blocking true cancer prevention.
In February
1992, Epstein and three colleagues - former directors of federal
agencies Drs. Eula Bingham and David Rall and Dr. Irwin D. Bross
- expressed concerns about the current "war against cancer" and
proposed reforms in a statement presented at a press conference.
The statement was endorsed by 64 leading national experts in
cancer prevention, public health, and preventive medicine. After
noting the continual rise in the incidence of cancer, the statement
reads: "We express further concerns that the generously funded
cancer establishment, the National Cancer Institute (NCI), the
American Cancer Society (ACS) and some 20 comprehensive cancer
centers, have misled and confused the public and Congress by
repeated claims that we are winning the war against cancer. In
fact, the cancer establishment has continually minimized the
evidence for increasing cancer rates, which it has largely attributed
to smoking and dietary fat, while discounting or ignoring the
causal role of avoidable exposures to industrial carcinogens
in the air, food, water, and the workplace."

ACS not only ignores environmental and occupational carcinogens,
the ACS has thrown the full weight of its prestige and money against
laws that ban the deliberate addition of carcinogenic substances
to foods and have campaigned for the continued use of
organochlorine pesticides, some of which are known to cause breast
cancer. "An economic boycott of the ACS," writes Epstein, "is
now well overdue."

Not all man-made chemicals are carcinogenic. In fact, less than
10% of 140 industrial compounds suspected of being carcinogenic
actually caused cancer in laboratory tests conducted from 1963
to 1969. The problem is that known carcinogens are permitted
in the workplace, air, water, food, and consumer products. Epstein
believes that organizing political action is needed to educate
the media, the public, and Congress that much cancer is avoidable
and to campaign for reduction in environmental carcinogens. He
urges readers to support public interest groups and/or organized
labor groups that have been responsible for many of the regulations
against carcinogens that are already in place. To encourage such
action, The Politics of Cancer Revisited contains a list
of activist and resource groups in the U.S. and U.K.

Epstein also encourages consumers to vote with their shopping
dollars. When companies see that consumers are spending money
on safer products, they will seek alternatives to the carcinogenic
products and processes that they presently use. Epstein refers
to a book that he wrote with David Steinman called The Safe Shopper's
Bible that informs consumers what products and food contain known
carcinogens. Not only will avoiding these products hurt the manufacturers'
pocketbook, it will also be a positive step in lessening one's
risk of cancer.

The Politics of Cancer Revisited thoroughly
depressed me. I knew that the "war on cancer" was a rip-off,
but I didn't realize the extent of the collusion. Too, I'm
depressed that
the rise in incidence of cancer directly correlates to the ubiquitous
use of carcinogens; and, no one - not government, not industry,
not the medical establishment - is making any attempt to find
or use less hazardous materials. We're paying the cost. The
Politics of Cancer Revisited reflects over 20 years of fighting
to have the truth known and recognized, Dr. Epstein has done
his part in educating, in getting out the message that much of
cancer is truly avoidable - not with magic drugs, or technological
diagnostic devices, but by removing carcinogens from consumer
products, workplaces, and the environment. It's up to use to
hear it and act.